Follicle-stimulating hormone (FSH) is an injectable protein falling into the class of gonadotrophins. FSH is used in the treatment of infertility and reproductive disorders in both female and male patients.
In nature, FSH is produced by the pituitary gland. For pharmaceutical use, FSH may be produced recombinantly (rFSH), or it may be isolated from the urine of postmenopausal females (uFSH).
FSH is used in female patients in ovulation induction (OI) and in controlled ovarian hyperstimulation (COH) for assisted reproductive technologies (ART). In a typical treatment regimen for ovulation induction, a patient is administered daily injections of FSH or a variant (about 75 to 300 IU FSH/day) for a period of from about 6 to about 12 days. In a typical treatment regimen for controlled ovarian hyperstimulation, a patient is administered daily injections of FSH or a variant (about 150-600 IU FSH/day) for a period of from about 6 to about 12 days.
FSH is also used to induce spermatogenesis in men suffering from oligospermia. A regimen using 150 IU FSH 3 times weekly in combination with 2′500 IU hCG twice weekly has been successful in achieving an improvement in sperm count in men suffering from hypogonadotrophic hypogonadism [Burgues et al.; Subcutaneous self-administration of highly purified follicle stimulating hormone and human chorionic gonadotrophin for the treatment of male hypogonadotrophic hypogonadism. Spanish Collaborative Group on Male Hypogonadotrophic Hypogonadism; Hum. Reprod.; 1997, 12, 980-6].
Because of the importance of FSH in the treatment of fertility disorders, the provision of FSH of high purity and high specific activity is desirable. FSH treatment requires repeated injections. Highly purified FSH preparations can be administered subcutaneously, permitting self-administration by the patient, thus increasing patient convenience and compliance.
Lynch et al. [The extraction and purification of human pituitary follicle-stimulating hormone and luteinising hormone; Acta Endocrinologica, 1988, 288, 12-19] describe a method for purifying human pituitary FSH. The method involves anion and cation exchange chromatography, immunoaffinity extraction and size exclusion chromatography. The method is said to result in pituitary FSH having a specific activity of 4,990 IU (immunoassay)/mg, with 16 IU/mg of LH. Protein content was determined either by dry weight or in solution by absorption at 280 nm (assuming that A1 cm280 for 1 g/l is equal to 1).
WO 98/20039 (IBSA Institut Biochimique SA) describes a process for the purification of human urinary FSH starting with urinary extracts called human menopausal gonadotrophins (hMG). The process uses ion-exchange chromatography on weakly basic anionic exchange resins of the DEAE type followed by affinity chromatography on resin having an anthraquinone derivative as a ligand. The process is said to yield urinary FSH free from LH and having a specific activity of 6,870 IU (immunoassay)/mg. Protein content was determined by assuming that a water solution of 1 mg/ml of protein has an optical density of 0.62 at 277 nm, in quartz cuvettes with a 1 cm path length.
WO 00/63248 (Instituto Massone SA) describes a process for the purification of gonadotrophins, including FSH, from human urine. The process involves the following steps: ion exchange chromatography with a strong cationic resin of the type sulphopropyl, ion exchange chromatography with a strong anionic resin, and hydrophobic interaction chromatography (HIC). A FSH preparation having a specific activity of 8,400 IU/mg (Steelman-Pohley method: Assay of the follicle stimulating hormone based on the augmentation with human chorionic gonadotrophin; Endocrinology; 1953, 53, 604-616) and less than 1 IU LH (rat seminal vesicle weight gain method: Van Hell H, Matthijsen R & G A Overbeek; Acta Endocrinol, 1964, 47, 409) biological activity per 75 IU FSH is reportedly obtained. Protein content was performed by the Lowry method [O. H. Lowry et al., J. Biol. Chem., 1951, 193, 265].
U.S. Pat. No. 5,990,288 (Musick et al.) describes a method for purifying FSH from biological samples, such as human pituitary glands or human post-menopausal urine. The process uses cation exchange chromatography on Fractogel EMD SO3-650M, followed by dye affinity chromatography on Mimetic Orange 1 resin, followed by a step of hydrophobic interaction chromatography on Bakerbond Wide Pore HI-Propyl resin. The process is said to result in human pituitary FSH having a specific activity of 7,066 IU (immunoassay)/mg and less than 1 IU (immunoassay)/mg of LH, and a urinary FSH having a specific activity of 6,298 IU (immunoassay)/mg and less than 3 IU (immunoassay)/mg of LH. Protein content was determined by absorption at 280 nm (assuming that A1 cm280 for 1 g/l is equal to 1).
Chiba et al. [Isolation and partial characterisation of LH, FSH and TSH from canine pituitary gland; Endocrinol. J., 1997, 44, 205-218] describe a technique for purifying canine pituitary gonadotrophins, including FSH, using Concanavalin (Con) A affinity chromatography, hydrophobic interaction chromatography (HIC) and immobilized metal ion chromatography with Cu++. The resulting FSH is reported to have a specific activity of 2.17 IU/g protein using a radioreceptor assay for FSH for measuring biological activity and the BioRad protein assay kit (BioRad Laboratories CA USA) for determining protein content.
WO 88/10270 (Instituto di Ricerca Cesare Serono SPA) describes a method for purifying human FSH from urine. The process involves immunochromatography with FSH-specific immobilized monoclonal antibodies bound to Sepharose 4B by divinyl sulphone, followed by reverse phase HPLC. The resulting FSH is free of LH and other urinary proteins and has a specific activity of 6,200 IU/mg of lyophilised powder (Steelman-Pohley method). The preparation was the first FSH preparation to be suitable for subcutaneous administration, due to its purity.
An ongoing need remains for new methods for purifying FSH and FSH variants. In particular, there is a need for purification methods that avoid the use of the cost-intensive immunoaffinity chromatography steps.